Individual
DR. JACK W TSAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DPHIL
Contact information
Practice address
1331 UNION AVE STE 1145, MEMPHIS, TN 38104-7509
(901) 448-7674
Mailing address
847 MONROE AVE STE 226, MEMPHIS, TN 38103-4901
(901) 448-7674
(901) 448-7440
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
51145
TN
2084N0400X
Neurology Physician
310245
NY
2084N0400X
Neurology Physician
Primary
51145
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03882085
—
MS
05
—
1437135084
—
MO
05
—
226224001
—
AR
05
—
Q031283
—
TN
Enumeration date
12/15/2005
Last updated
04/25/2023
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